Cow metritis，with strong concealment，high incidence and great harm，seriously damages the reproductive capacity of dairy cows，and has been considered as one of the major factors restricting the benefits of farms. Against which，antibiotic therapy is commonly used，but its shortages in bacterial resistance and antibiotic residues are found. The key to prevent and control the disease relies on accurate diagnosis，early prevention and alternative therapy. For diagnosis，cytology，rectovaginal examination，B-ultrasonic examination and PCR assay are commonly used，but a more simple and rapid diagnostic method and diagnostic criteria are required. With early warning，such as indicator early warning and genome prediction，any occurrence of cow metritis could be predicted and prevented as early as possible，but early warning indicators should be confirmed in combination with large amount of samples and local environment to improve the accuracy of early warning. More scientific researches have focused on the development of“alternative antibiotics”therapy，such as replacement of antibiotics with chitosan particles，essential oil，ozone，probiotics，vaccines and recombinant interleukin-8，but a large number of clinical experiments and evaluation are still required to fully remove antibiotic residues. The overview of the above researches will provide a reference for the diagnosis，prevention and treatment of cow metritis，and supports for reducing the incidence rate，bacterial resistance and antibiotic residues，and for improving the efficiency of breeding.